If you are at intermediate or high risk but don't have symptoms, there is not enough evidence to say one way or the other whether an EKG will help predict heart disease, says Joy Melnikow, MD, PhD, a member of the task force.

The updated recommendations focus on a specific group, Melnikow says. "This recommendation addresses people without any symptoms of heart disease who are coming to their doctor to find out what they need to do to be healthier."

The task force is an independent panel of experts that considers multiple sources of evidence and makes recommendations about preventive services and tests.

The task force focused on just the EKG, which checks for problems with the heart's electrical activity. It is often done to find the cause of symptoms such as chest pain. An EKG can be a resting EKG or an exercise EKG, also called a treadmill test.

The task force guidelines are published in the Annals of Internal Medicine.

EKG Recommendations in Detail

The panel asked one question, says Melnikow, professor of family and community medicine at the University of California, Davis. "Once [a person is] evaluated for other risk factors for heart disease -- such as smoking, high cholesterol, sedentary lifestyle, high blood pressure -- does it help to add a screening test with either a resting ECG or an exercise ECG?"

"Our answer is, the net benefit of that is zero or possibly slight harm in low-risk people," Melnikow says.

Among the possible harms are false-positive EKGs. Those could lead to unnecessary procedures such as angioplasty, she says.

For intermediate- and high-risk adults, the evidence was not sufficient to make a recommendation, the task force says.

"I think doctors [sometimes] do an EKG to avoid missing a major abnormality," Dave says. "What we can get from this study is, the evidence suggests there is no need to do a routine EKG on a low-risk person without symptoms."

Suzanne Steinbaum, DO, director of women and heart disease at Lenox Hill Hospital, New York, doesn't agree totally with the new EKG recommendations.

For those who are low risk and without symptoms of heart disease, she agrees that repeated EKGs done routinely over the years are not necessary.

However, she says, "I think everyone needs an EKG at some point in their life when they are healthy."

This EKG can then serve as a comparison later, if symptoms occur and an EKG is ordered, says Steinbaum.

Routine EKGs: Other Guidelines

The American Academy of Family Physicians does not recommend routine EKGs as part of a periodic health exam in adults without symptoms.

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However, the American College of Cardiology Foundation and the American Heart Association state that a resting EKG is ''reasonable" to assess risk in an adult with no symptoms who has high blood pressure or diabetes.